Provider Demographics
NPI:1336394717
Name:BHS CENTRAL PHARMACY
Entity type:Organization
Organization Name:BHS CENTRAL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:B
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:920-324-1601
Mailing Address - Street 1:208 S WEST ST
Mailing Address - Street 2:
Mailing Address - City:WAUPUN
Mailing Address - State:WI
Mailing Address - Zip Code:53963-1629
Mailing Address - Country:US
Mailing Address - Phone:920-324-1600
Mailing Address - Fax:920-324-1590
Practice Address - Street 1:208 S WEST ST
Practice Address - Street 2:
Practice Address - City:WAUPUN
Practice Address - State:WI
Practice Address - Zip Code:53963-1629
Practice Address - Country:US
Practice Address - Phone:920-324-1600
Practice Address - Fax:920-324-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-26
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8862-0423336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy